This study aimed to develop a new infected wound model caused by bacterial inoculation on wound surface in rats. A full-thickness wound was created on the dorsal skin of six-month-old male Sprague-Dawley rats. A piece of gauze was incubated with bacterial solution (a wild-type strain of Pseudomonas aeruginosa, OD600=1.0) for 1.5 h prior to application, for 72 h onto the wound surface on post-wounding day 1. A piece of gauze was incubated without bacteria for control group. The wound tissue was collected on post-wounding day 6. Macroscopic observation showed erythema in the periwound skin in the infection group on post-wounding day 6. The relative wound area to the baseline value of the infection group was significantly larger than that of the control group on post-wounding day 6 (0.8±0.1 vs 0.6±0.1, p=0.011). Myeloperoxidase was abundant in the infection group compared with the control group. P. aeruginosa was detected inside the wounds in the infected group via immunohistochemistry. Our new infected wound model can mimic a clinical cutaneous infected wound.

In Japan, about 80% deliveries occur in a ward shared by Obstetrics and other departments, and studies have revealed that nurses have overlapping duties in assisting with delivery and caring for dying patients from other departments. Moreover, 68.2% of deliveries in the maternity ward are high risk, so there are concerns about the safety of the delivery environment. Thus, the current study sought to ascertain the realities of care in a maternity ward providing round-the-clock critical care to high-risk mothers. This study also sought to examine the nature of perinatal care. This study used beacons and smartphones to reveal the locations visited by midwives and the duration spent in each. When sudden events occurred, over half of the midwives were assigned to delivery areas to ensure the survival of the mother and infant, and they provided patients with needed care without reducing the duration of time they spent in patient rooms and neonatal rooms. The outcomes of collaboration among members of the care team were associated with the fact that this study was conducted at a facility dedicated to perinatal care.

The purpose of this study was to develop a method for more accurate evaluation of fecal retention by an artificial intelligence interpretation support application that determines and displays in red extraction area the presence of fecal retention for rectal ultrasonographic videos taken by home-visiting nurses. In this study, static images were output from rectal ultrasonographic videos taken from medical records of one home-care nursing station. For each static image, the ultrasound expert and the application judged the presence of fecal retention based on half-moon or crescent-shaped hyperechoic findings as extraction area. This study focused on images that were false-positive results for the application when the ultrasound expert’s answer was correct. Extracted regions with a depth of less than 50 mm and a longitudinal diameter of less than 14.5 mm were excluded to distinguish them from stool and gas retentions outside the rectum. As a result, the sensitivity was 81.1%, specificity 87.8%, and correct rate 83.7%. A method of adjusting the depth and long diameter of the extraction area was developed as a means for improving the judgement accuracy of the application.

In this study, nursing students were classified into two groups and the effects of mindfulness were investigated from a physiological perspective. The subjects (20 people) were randomly divided into two groups, and EEG was measured during the task in the group that applied mindfulness and the group that did not apply mindfulness during 5 days. The analysis points were theta, alpha, and beta waves during the task in both groups, and the power spectrum values of each frequency band were compared. The results suggested that mindfulness had a relaxation effect during the task and maintained attention after the task was completed. All the subjects in the mindfulness group practiced mindfulness continuously for five days during the experimental period, and the relaxation effect was sustained even when they did not practice mindfulness in a situation of reduced tension. These results suggest that mindfulness is useful for task performance and relaxation.

The aim of this study was to examine the effectiveness of headband (HB) usage for nurses to mask ventilation. This study was a randomized crossover trial focusing on ventilation volume and mask fit pressure distribution. Forty nurses participated in this study. Subjects performed a mask fit using the C method (E-C usage method only) and H method (E-C usage method with HB) on the airway simulator. In addition to the ventilation volume, we measured the mask’s pressure distribution using a pressure measurement sheet. Ventilation volume was significantly higher with the H method than the C method. Pressure was significantly higher on the nose, right cheek and both corners of the mouth with the H method. Furthermore, the pressurized area was significantly higher at all sites except the jaw using the H method. The difference in maximum ventilation volumes between the C and H methods was most affected by the difference in the pressurized area at the right corner of the mouth. These results suggested that nurses’ HB use for mask ventilation could increase ventilation volume by covering a mask fit ventilation on the right corner of the mouth compared with the E-C method.

After being permitted as a food additive in 2002, slightly acidic electrolyzed water (SAEW) was expected to be a low-irritant disinfectant. However, its safety when applied on human skin has not yet been confirmed. This study aimed to identify the toxicity of SAEW for human skin. This double-blind, placebo-controlled trial included 20 subjects ranging in age from 20 to 50 years who had normal skin on their forearms at the time of study entry. Two spray bottles, A and B, containing SAEW or distilled water (DW), were distributed to all subjects. The reagents were randomly assigned so that neither the subjects nor the researchers knew which container, A or B, contained the SAEW or DW. The subjects applied a single spray (approx. 2 mL) of A and B to their left and right forearms, respectively, once daily for one week as the intervention period. The subjects were instructed not to touch or rub the sprayed areas of their forearms until the reagent had dried. To assess the resultant skin condition, stratum corneum hydration, sebum secretion, transepidermal water loss, skin pH, resident flora, and multiple biomarker assay of tape-stripped stratum corneum from the site of the forearm where the spray was applied were evaluated before and after the intervention period. The results showed that there were no differences between the skin sprayed with SAEW and DW both before and after the intervention period. In addition, SAEW did not induce any skin irritation. Our findings suggested that SAEW can be safely applied on human skin.

Generally inflammatory reactions induced by infusion phlebitis are assessed subjectively as a part of nursing care which is known as macroscopic findings. For achieving accurate inference from this method of subjective assessment, multiple checks by multiple persons are needed. In order to reduce the human workload of subjective evaluation, an objective assessment measure for the inflammatory reactions induced by infusion phlebitis is necessary. In this work, the first quartiles of each of the two parameters of the L＊a＊b＊ color space that represent the changes in brightness and color respectively, from the captured images of inflammatory reactions over a period of time, are used to define the features corresponding to the amount of shape change of histogram over time representing the progress or recovery of the inflammatory reaction. Next, by using multiple cases of different degrees of inflammatory reaction, an objective assessment measure based on the above definition has been proposed. It is seen in the experimental results that the proposed objective measure can assess the inflammatory reactions correctly in accordance to the results obtained by the subjective assessment.

Due to the small number of staff working night shifts in hospitals, there are concerns about whether the time spent caring for parturient women decreases the availability of care for other patients. This study aimed to investigate how the presence of parturient women influences the length of time that nurses and midwives spend in other patients’ rooms during a night shift in a mixed obstetric ward. The location and length of stay were measured using a wireless communication device, and the median length of stay in the 5-night shifts in the presence of parturient women were compared with that of the 7- night shifts in the absence of parturient women. The results revealed that when parturient women were present in the ward, midwives showed a significant increase in the length of stay in the delivery area, while nurses showed a significant increase in the length of stay in the obstetric 4-bed rooms, and a significant decrease in the rest area. Even when parturient women were present during the night shift in a mixed obstetric ward, a significant reduction was not observed in the length of stay in other patients’ rooms due to the collaboration of nurses and midwives.

Many adult women complain of symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). An accurate distinction between women with PMS or PMDD and healthy women is difficult because their symptoms vary and range from physical to mental symptoms. This study aimed to develop a method for the distinction between subjects with PMDD or PMS and healthy women based on clustering the Profile of Mood States 2nd Edition (POMS〓2) scores. Nineteen adult women aged 20〓22 years (three PMDD subjects, five PMS subjects, 11 non-PMS subjects) were included in this study. The abridged Japanese version of POMS〓2 was administered to the subjects during their follicular and luteal phases. All subjects were clustered based on the scores on the subscales of the POMS〓2 analysed by the ward method. In the follicular phase, the subjects were divided into two clusters. The subjects classified into cluster 1, which consisted of 9 non-PMS, had higher scores in Friendliness and Vigor-Activity. In contrast, cluster 2 consisted of all subjects with PMS or PMDD and two non-PMS women who seem to have mild PMS. A method based on scores of POMS〓2 in the follicular phase has been proposed as a way to distinguish between women with PMS or PMDD and healthy women.

In order to reduce the pain of needle insertion for hemodialysis patients, a regional cooling pad was designed and evaluated on both a polyethylene plate and the forearms of healthy subjects (n=8). The cooling pad was fabricated with a cotton sheet and urea particles of less than 1 mm in diameter, or urea powder. Water to dissolve the urea in a heat absorption reaction was added at constant rate of 0.5 mL/s using a linear actuator. The subcutaneous tissue thickness of the healthy subjects was measured by echography. The time required to reach a skin temperature of 25 degrees Celsius (t25) and the period during which the skin had a temperature under 25 degrees Celsius (T) were compared. The t25 of the pad with urea particles was 17 seconds, and that of the pad with urea powder was 7 seconds. T was more than 390 seconds. Temperature gradients calculated with subcutaneous tissue thickness showed a positive correlation with heat flux. Initial skin temperature showed a negative correlation with T.

Background: Dehydration is caused by water and salt loss in the body, resulting in elevated serum osmolality (SOsm). Older adults are susceptible to dehydration because of age-related alterations, however, the prevalence is not well documented in community. This study aimed to investigate the prevalence of dehydration among older adults in a home care setting in Japan. Methods: A cross-sectional observational study was conducted in 33 older adults. Age, sex, Nursing Need Level, cognitive function, water intake, body mass index, vital signs, dehydration signs/symptoms and a blood test result were obtained. SOsm was used to identify dehydration (291≦SOsm＜300 mOsm/L: Impending dehydration, 300≦SOsm: Dehydration). Results: The mean participant age was 84±6 years old, with 24 women (72.7%). Twenty-two participants (66.7%) had SOsm of 291 mOsm/L or more and no acute episodes of dehydration. Sensitivity and specificity of the signs and symptoms was 77.3% and 18.2%, respectively. Cognitive function was inversely correlated with SOsm and water intake was varied between the Nursing Need Levels. Conclusions: There was a high prevalence of dehydration among the older adults in home care setting. The dehydrated condition might have been proceeding chronically. The risk of dehydration could be overlooked in the persons with comparatively better cognitive and physical functions in the home care setting.

This study aimed to compare the effect of three types of dressings on enhancing heel pressure and shear force reduction at elevating head-of-bed angles at a spine position. A total of 26 healthy volunteers participated. A three-axis tactile sensor was directly applied on the interface of the heel and then covered with the following three dressings: film dressing (as a control), low frictional outer layered hydrocolloid dressing (LFH dressing), and multilayered silicone foam dressing (MSF dressing). The interface pressure and shear force were measured by the sensor at 0, 30, 45, and 60 degrees of the elevated head-of-bed angle. The pressure and shear force in all axis directions in the LFH dressing was equivalent compared with those in the MSF dressing, while those in the film dressing reached to be higher (p<0.05). The relative value of vertical shear force to pressure for the LFH and MSF dressings was approximately 1.0, while that in the film dressing was 1.7. In conclusion, the LFH and MSF dressings reduced pressure and shear forces at head-of-bed elevation, compared with the film dressing, and were considered available for preventing heel pressure injury.

This pilot study evaluated the operability and visualization capabilities of a prototype that uses near-infrared light reflection to visualize peripheral veins. Nurses evaluated the prototypes to perform peripheral venous access using a covered needle. We investigated 28 invisible veins in healthy volunteers, and the diameters and depths of the veins were measured using ultrasound. Qualitative operability data were obtained from interviews. Quantitative visualization capability data regarding the near-infrared light vascular images produced by the prototype were collected using the Likert scale. We obtained two results: 1) According to the interviewed nurses, the prototype with a personal tablet display near a participant’s arm was easier to operate for the simulation of a blood sampling, and 2) the successful visualization rate for invisible veins using the prototype with the tablet display was 42.9%. The nonvisualized veins were deeper than the visualized veins. The vein depth cut-off ranged from 3.0 to 3.3 mm for nonvisualized and visualized veins (AUC=0.987). Our results indicate that the vein visualization device needs to be developed based on a tablet display type located near a participant’s arm, and it is necessary to visualize invisible veins with a depth of 3 mm or more.

Slightly acidic electrolyzed water (SAEW) with pH 5.0-6.5, which is produced by electrolyzing diluted hydrochloric acid, has been used as both a sanitizer against foodborne pathogens on fresh foods and a skin disinfectant. However, with the chloride concentration available at present (10-30 ppm), SAEW has been reported to be unable to eliminate Mycobacterium tuberculosis, the causative agent of tuberculosis. In the present study, we investigated damage in mammalian cells after incubation with a medium containing SAEW with various chloride concentrations (0, 25, 50, 75, and 100 ppm) using crystal violet or trypan blue staining. Only slight damage to mammalian cells was observed with chloride concentrations of 25-75 ppm, but with a concentration of 100 ppm, severe damage was seen. Taken together, these findings suggest that SAEW has a small effect on the skin at chloride concentrations up to 75 ppm.

In this study, we examined the circadian rhythms of cortisol and chromogranin A (CgA) in intensive care unit (ICU) nurses to clarify whether they are able to relieve stress sufficiently on rest days. Method: The saliva samples were collected by 29 ICU nurses at 08:00, 12:00, 16:00, and 20:00 on a working day (WD) and a non-working day (NWD) and analyzed for cortisol and CgA levels. Results: The participants were between 20〓50 years old (female: 26, male: 3). The subjective stress was high among the majority of the participants in WD, especially during working hours (12:00 and 16:00). Salivary cortisol levels on WD and NWD reflected the diurnal pattern with no significant differences. The circadian pattern of salivary CgA on WD was different from that of NWD, even though it was not statistically significant. The intensity of subjective stress did not have a relationship with either salivary cortisol or CgA levels. Conclusions: Neither the work status nor the subjective stress significantly changed the diurnal salivary cortisol pattern. The non-significant differences in circadian patterns of sCgA levels between WD and NWD might be associated with job strain. The results indicate inadequate stress relief in NWD among ICU nurses.

We verified the effectiveness of heat retention after foot baths for women with a large temperature difference between central and peripheral areas. Twenty-four young women were recruited between July and October 2018. The experimental method involved performing foot baths for 20 minutes after which the participants sat in a resting position. The deep body temperature of the participants was continuously monitored for 20 minutes after the experiment. Post-foot bath experiments were conducted with and without heat retention (i.e., the use of tubular covers for lower legs) for two consecutive days. Coldness was classified into four types based on the deep temperature difference between the forehead and the lower leg or instep of the foot. Among participants who showed a large difference in deep temperature between the forehead and the lower leg as well as the instep, there was no significant difference between the deep temperature of the lower leg at rest and 20 minutes after the foot bath without heat retention (p=0.051). Temperature increased significantly with heat retention (p=0.012). We suggest that heat retention after foot bath is an effective method to maintain the temperature for women with coldness.

The purpose of this study was to clarify the effects of lower leg exercise by subjective evaluation and changes in deep body temperature. Methods: This study was conducted from March to November 2020 and enrolled 17 healthy women (mean age 22.8 years). The study period was 7 days. Lower leg exercise was performed using an original exercise device. Participants were divided into two the coldness and non-coldness groups according to reference of a deep body temperature difference of 2.55℃ between the forehead and instep. We performed the subjective assessment of effects of exercise during a one-week period and evaluated the resulting changes in deep body temperature. A generalized linear mixed model was used to analyse the changes in deep body temperature. Results: Post-exercise, deep body temperature in the instep significantly increased in the coldness group. The difference in deep body temperature following the leg exercise between the forehead and instep significantly decreased in the coldness group. With regards subjective evaluation, all participants reported that their feet were warm after lower leg exercise, irrespective of the group. Conclusion: This study indicates that lower leg exercise may be effective in improving blood flow in the instep of young women with coldness.

We aimed to develop a method to automatically evaluate pelvic floor muscle (PFM) contractions using transperineal ultrasound movies of male patients after radical prostatectomy. Methods: Forty transperineal ultrasound movies obtained in a previous study were used. From the discussion between two expert PFM trainers and automatic trackability, the distance from the pubis to the anorectal junction was determined to be the primary parameter. Seven algorithms were tested to track the pubis and the anorectal junction. The pubis-anorectal junction distance, measured using a software, were compared on two levels of PFM contraction (good/moderate) subjectively evaluated. Result: Among the seven algorithms, Kernelized Correlation Filter could track the pubis and the anorectal junction during PFM contraction in the 40 movies. The frame rate (fps) was 66〓77 in the Kernelized Correlation Filter. The changing rates of the pubis-anorectal junction distance in the vector and the X-axis lengths were significantly different between the good and moderate contractions that were subjectively evaluated. Conclusion: A method for tracking the pubis and the anorectal junction in ultrasound movies after radical prostatectomy was developed to automatically evaluate PFM contractions.

In this study, the Lyapunov exponent (LE) of heart rate variability (HRV) is investigated for feasibility as an index of hemodynamics. In a previous study, we calculated the HRV and evaluated blood pressure fluctuations via the autonomic nervous activity during standing. Herein, we examine the LE of HRV using resampled electrocardiogram (ECG) R-R interval (RRI) data. ECG and blood pressure measurements were obtained from healthy young (<30 years) and older (〓65 years) subjects during rest-to-stand motion experiments. The LE calculated from HRV measurements were lower in older participants than young participants. In both age groups, the LE decreased when the RRI and blood pressure decreased. However, the LE was not significantly correlated with either the RRI or blood pressure. Further, the LE was not significantly correlated with the indices of autonomic nervous system activity. Thus, the LE could be used as an independent index to monitor fluctuations in circulatory dynamics. We believe that this preliminary work will be of use in developing medical applications using the LE for telemedicine and home nursing.

In recent years, nurses’ visual information has been used in research on nurses’ clinical decision-making ability and medical safety, but it is assumed that such analyses are extremely time-consuming and expensive. This study was implemented to clarify whether Mask R-CNN (which captures image features and groups them) can automatically detect objects in nurses’ visual fields and whether it can reduce the labor and time required for visual field analysis. We collected 789 images of “infusion” and 1,136 images of a “catheter hub” from the visual field images of six nurses and used them to train Mask R-CNN. Our results showed that detection sensitivity, number of false positives per image, and Dice index (representing area coincidence) of “infusion” were 90.1%, 0.109, and 0.765, while for “catheter hub” the corresponding values were 50.8%, 0.308, and 0.205, respectively. Next, we checked whether the task of specifying the gazing point could be shortened using Mask R-CNN for the visual field images of two subjects and found that the task time could be reduced by 18.7%. In future work, we will study the method of training Mask R-CNN and aim to increase the amount of data to improve the accuracy of object detection.

Because biofilm infection is a major cause of hard-to-heal wounds, biofilm detection is essential for prevention and management of hard-to-heal wounds. We newly developed a simple, rapid, and safe staining method of biofilms, liquid-less staining. In this study, we evaluated the liquid-less staining in comparison with the conventional method. We prepared dot blot samples of different concentration of artificial biofilms, and stained with the conventional and liquid-less staining. The liquid-less method detected the signals of lower concentration of biofilms than the conventional method in subjective evaluation. Although the quantitative evaluation showed similar signal-noise ratio and correlation between signal intensity and the concentration of biofilms, the liquid-less method was superior to the conventional method in signal stability. The liquid-less staining method is expected to be applied for the point-of-care biofilm testing in home care settings.

The usefulness of stretching to improve cold sensitivity in healthy adults was investigated using skin surface temperature and finger plethysmography. Thirty-one healthy adults in the age group of 20〓25 years were divided into two groups: high upper-limb muscle mass group and low upper-limb muscle mass group. In experiment one, two rounds of hand bath were performed. In experiment two, one round of hand bath and one round of stretching followed by hand bath were performed. In both experiments, pulse wave amplitude and skin surface temperature were measured for ten minutes after hand bath and the temperatures of both the groups were compared. For the high group, the pulse wave amplitude and skin surface temperature did not change in both the experiments compared to the resting state. In experiment two, the pulse wave amplitude at rest, after the hand bath and after stretching and hand bath, were significantly higher for the low group than that of the high group. Moreover, the skin surface temperature in experiment two was significantly higher than in experiment one after zero, two, four, and six minutes. Therefore, stretching has improved the cold sensitivity for the low muscle mass group.

The aim of this study was to investigate the incidence of aspiration pneumonia and the characteristics of patients with aspiration pneumonia after admission to an acute hospital using a nursing screening flowchart. A cross-sectional survey was conducted from October 2020 to January 2021. In this study, we used the Dysphagia and Aspiration Pneumonia Patients’ Screening flowchart (DAS flowchart) we developed to identify hospitalized patients with aspiration pneumonia. Over the study period, 97 of 10,039 hospitalized patients were suspected to have or were diagnosed with pneumonia. Of these 97 patients, 73 (75.3%) patients had aspiration pneumonia. Thus, we determined that the incidence rate of aspiration pneumonia in this study was 0.73%. At least two of the following three physician’s diagnostic parameters were observed in 48 of the 73 patients (65.8%): body temperature 〓37.5℃, C-reactive protein level 〓20 mg/L, and white blood cell count 〓9,000/〓L. The DAS flowchart may be used to identify patients with aspiration pneumonia. However, further research is needed to investigate the validity of the DAS flowchart.